HomeMy WebLinkAboutPERMIT 2210 Arapaho Rd Gas Line 2019-08-16KI UMV
AUS 162019
Town of Estes Park Permit Number
Received $y.,.,.Application for Miscellaneous Permit APPlication Explres4jjk ‘‘flepn aitdia,g Sa1e 170 MacGregorAvenue P.O.Bo 1200 Est Part CO 80517GeneralInformation&Isispection Line (970)577-3726 FAX (970)586-0249 *-ti’;n Pennit Expires
Job Address:22/C 14’rct pct hoe.‘?4 EsIr Mx dCfosn
Owner Name:&ra-t I/tin nc/C Phone:‘776 67.7 t95S
Address:22-/C /-}ra,aaAoc r1I FsIesL-k Pt 5/7(Street)(City)(Slate)(Zip’Cod&r
Contractor/Applicant:Fy re rik.License #:[62 PJionc:’?7O ‘3zZAddress:53 3 5 .:ber line L±rt eDI Iiii C 2 sz2___(Street)(City)(State)(Zip Code).ajongterm Residential (?30 days)U Short-term Residential (<30 days)U Comntercial
0 Replace Furnace XCas Line (7 ft.)0 Replace Boiler 0 Replace WindowsUReplaceHotWaterHeater0InstallAirConditioningCMinorPlumbingCTemporaryStructureUse________________C Minor Remodel Time PeriodInsert—circle on Gas,Wood,Pellet;U Other
1)scription of Work:
.%j prc 4 .t.alaft4rnaIatc--t i’rtfA-ztti neiV 701 se-I--V;ilnation (Total Cost of Material &Labor):$/âô
I certity bit apptic.tion is hue and coned anti aster to perfonu the work described according lo ptatis’spccthcations sithotitted,reviewed and approved,and conpiyw ithlocalantsn;nccs,state and tedceat taos as well as buitdino cod.I certify that t have the property o;vncrs auth onty anti permission to apply Cit this patoiS.AstdiUonaWv,UNDERSTAND THAT I AM RESPONSIItLE FOR ANY FEES OR E0’ENSfS INCORRED FOR PLAN REVIEW,PERMITS,INSPECTIONS AND OTHERFEESASSOCIATFI)WITH THIS APPLICATION.Note:The work authorized by tins permit requires Itie building be provided with smoke alarms contptyingwitttnautticipatcodes.
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Inspection Checklist
C Address Posted U Equipment Access U -r &P U Smoke DetectorsUContractorsi.icensed U Equiptncnt Listed U Gas Pipe U Rough ItsspectiesnUPermitPacketAvailableUEquipmentClearancesUVentUFinalinspectionUSafeAccessUPanandDrainI]Combustion Air
Coattastents:
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County Tax:‘BuDding Offleiaii Date -I ---‘Iota!:
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Receiveit Date
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